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肺气肿:肺切面大量扩张含气区


肺切面可见肺气肿扩张的含气区。重复感染致瘢痕形成,肺实质破坏,而不会纤维化。肺气肿主要有 2 种的类型: 腺泡中央型和全腺泡型。前者主要累及肺上叶,而后者则累及整个肺叶,尤其是肺底部。
当腺泡近端的呼吸性细支气管扩张,而远端的肺泡扩张不明显,腺泡中央型肺气肿就会发生。 多见于吸烟。全腺泡型肺气肿发生时则出现从呼吸性细支气管到肺泡的腺泡所有部分全部扩张。多见于α-1-抗胰蛋白酶缺乏。
On cut section of the lung, the dilated airspaces with emphysema are seen. Although there tends to be some scarring with time because of superimposed infections, the emphysematous process is one of loss of lung parenchyma, not fibrosis. There are two major types of emphysema: centrilobular (centriacinar) and panlobular (panacinar). The former involves primarily the upper lobes while the latter involves all lung fields, particularly the bases. Centrilobular emphysema occurs with loss of the respiratory bronchioles in the proximal portion of the acinus, with sparing of distal alveoli. This pattern is most typical for smokers.Panacinar emphysema occurs with loss of all portions of the acinus from the respiratory bronchiole to the alveoli. This pattern is typical for alpha-1-antitrypsin deficiency.

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